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Wolfgang Miesbach – Targeting VEGF to Stop GI Bleeding: Systemic Bevacizumab

Wolfgang Miesbach/LinkedIn

Dec 16, 2025, 22:16

Wolfgang Miesbach – Targeting VEGF to Stop GI Bleeding: Systemic Bevacizumab

Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared on LinkedIn:

“Targeting VEGF to Stop GI Bleeding: Systemic Bevacizumab
Exciting data from ASH25! Dr. Nardeen Ayad presented compelling long-term results on systemic bevacizumab—a monoclonal antibody targeting VEGF-A to inhibit abnormal angiogenesis—for severe, chronic GI bleeding.

Wolfgang Miesbach - Targeting VEGF to Stop GI Bleeding: Systemic Bevacizumab

The Cohort (N=23):
The study followed 23 patients for up to 4.2 years.
These were complex, real-world cases:
Advanced Age: Median 78 years (range 42–90).
High Comorbidity: 56% Heart Failure, 26% Aortic Stenosis, 74% Hypertension.
Complex Etiology: 40% Idiopathic Angiodysplasia, 30% Type 2 VWD / Acquired VWS, 30% Chronic Liver Disease.

Wolfgang Miesbach - Targeting VEGF to Stop GI Bleeding: Systemic Bevacizumab

Clinical Impact:
The primary endpoint was the Hematologic Support Score (HSS)—a composite metric calculated as (Units RBCs Transfused) + (mg Elemental Iron Infused / 250).
– HSS Score: Dropped from 14.2 (baseline) to 0.6 (1 year) (P<0.001).
– Transfusions: Median RBC units went from 8 (pre-treatment) to ZERO.
– Utilization: ER visits/admissions cut significantly (3.5 → 1 per year).

Safety:
No thromboembolic events recorded despite high CV risk.
By targeting the underlying vascular pathology, bevacizumab is proving to be a safe, effective long-term option for older, comorbid patients who have exhausted standard therapies.

Is anti-angiogenic therapy now part of our algorithm for refractory angiodysplasia?”

Read more from Wolfgang Miesbach on Hemostasis Today.